Chronic obstructive pulmonary disease (COPD) and heart failure(HF) commonly occur in the same patient and the presence of onewill affect the prognosis from the other. There is a growing body ofevidence linking COPD and vascular events. When the NationalHealth and Nutrition Examination Survey population was stratified by forced expiratory volume in 1 s (FEV₁) and examined forcause of death, then the risk of death from cardiovascular disease was as much as fivefold greater in those with the lowest FEV₁ compared to the highest. Studies in Malmo and Baltimore showed thatthose with the most...

Chronic obstructive pulmonary disease (COPD) and heart failure(HF) commonly occur in the same patient and the presence of onewill affect the prognosis from the other. There is a growing body ofevidence linking COPD and vascular events. When the NationalHealth and Nutrition Examination Survey population was stratified by forced expiratory volume in 1 s (FEV₁) and examined forcause of death, then the risk of death from cardiovascular disease was as much as fivefold greater in those with the lowest FEV₁ compared to the highest. Studies in Malmo and Baltimore showed thatthose with the most rapidly declining FEV₁ were most likely to dieof cardiovascular disease. Low baseline FEV₁ also predicts strokemortality, all-cause cancer mortality, and death from nonrespiratory, noncardiac causes. Thus cardiac disease and respiratoryfunction are strongly correlated: although smoking is the obviouscommon risk factor, the relationship still stands in nonsmokers. Itis possible that FEV₁ is a marker for an ill-defined environmentalfactor such as poor nutrition but it could also be a marker of asystemic process of chronic tissue damage and abnormal repair.